Method and Apparatus for Altering Biomechanics of the Articular Joints
AssigneeCotera, Inc.
InventorsVivek Shenoy, Mark Deem, Hanson S. Gifford, Darin Gittings, Jeffrey J. Grainger, John Morriss
Life of this patent
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Abstract
Pathology of the human knee can arise from excessive and/or uneven loading of regions within the joint. Methods and apparatus are disclosed that enable displacement of soft tissue around the knee, without displacing or severing bone thereby altering the mechanical load distribution within the joint in a less invasive manner than previous techniques.
Claims152
An apparatus for treating disorders of the knee within at least one of the medial or lateral compartment of the knee, the apparatus comprising a prosthesis configured to be mounted to at least one of the femur or tibia proximate the knee joint in engagement with a target tissue for intervention, said target tissue comprising at least one medially or laterally positioned connective tissue of the knee, said prosthesis being configured and dimensioned so as to displace said medial or lateral connective tissue sufficiently to alter the location, angle or magnitude of forces exerted thereby on the knee so as to achieve a therapeutic effect in the at least one of medial or lateral compartment.
An apparatus for treating disorders of the knee, comprising an at least substantially rigid prosthesis formed around a first axis lying in a first plane, the prosthesis comprising:
- a fixation portion configured and dimensioned to be mounted to bone at a fixation site adjacent the knee, the fixation portion lying substantially in said first plane with a generally elongate shape oriented along said first axis and having first and second ends and at least a first width,
- a displacement portion configured to engage and displace a connective tissue of the knee targeted for treatment, the displacement portion having an outer, convex bearing surface spaced from the second end of said fixation portion in a direction along said axis and in a direction perpendicular to said first plane, and an inner concave inner surface facing said first plane, the displacement portion having a second width greater than the first width of said fixation portion;
- and
- a spanning section extending between the second end of said fixation portion and the displacement portion at an angle of between about 40 and 50 degrees with respect to said first plane.
An apparatus for treating disorders of the knee, comprising an at least substantially rigid prosthesis formed around a first axis lying in a first plane, the prosthesis comprising:
- a fixation portion configured and dimensioned to be mounted to bone at a fixation site adjacent the knee, the fixation portion lying substantially in said first plane with a generally elongate shape oriented along said first axis and having first and second ends and at least a first width,
- a displacement portion configured to engage and displace a connective tissue of the knee targeted for treatment, the displacement portion being positioned at an angle with respect to the fixation portion and having an outer, convex bearing surface and an inner concave surface, said surfaces spaced from the second end of said fixation portion in a direction along said axis and in a direction perpendicular to the axis, the convex bearing surface further having a generally arcuate shape formed around an axis parallel to and spaced from the first axis, the displacement portion having a width substantially the same as the first width;
- and
- a spanning section extending between the second end of said fixation portion and the displacement portion.
An apparatus for treating disorders of the knee, the apparatus comprising a prosthesis configured to be secured to the femur proximate the lower extremity of the femur in engagement with at least one connective tissue of the knee, said prosthesis being configured and dimensioned so as to displace said at least one connective tissue sufficiently to alter the location, angle or magnitude of forces exerted thereby on the knee so as to achieve a therapeutic effect at an articular surface of the knee
A prosthesis for treating disorders of the knee in the patellofemoral compartment of the knee, the prosthesis comprising:
- a fixation portion configured to be mounted to the tibia proximate the upper tibial extremity and medially of the tibial tuberosity;
- a spanning section configured and dimensioned to extend laterally from the fixation portion;
- and
- a displacement portion configured and dimensioned to (i) extend from the spanning section laterally under patellar tendon and in engagement therewith, and (ii) displace the patellar tendon anteriorly sufficiently to alter the location, angle or magnitude of forces exerted thereby on the patella so as to achieve a therapeutic effect in patellofemoral compartment of the knee.
A method of treating a knee joint to achieve a therapeutic effect wherein the therapeutic effect includes reduction of loading in a targeted region of the knee, comprising:
- selecting at least one of the muscles or connective tissues extending laterally or medially along the knee joint as target tissue for treatment;
- and
- displacing said target tissue sufficiently to alter the location, angle or magnitude of forces exerted thereby without displacing or severing any bones of the knee joint;
- wherein said displacing redistributes loading within the knee joint to achieve said therapeutic effect.
A method of treating a knee joint, the method comprising:
- selecting at least one of the muscles or connective tissues surrounding the knee joint as target tissue for treatment;
- attaching a device to the tibia at an attachment site inferior to an attachment point of the patellar tendon to the tibia, said device in engagement with the target tissue;
- and
- displacing said target tissue by more than about 5 mm from a pretreatment path with said device without severing the tibia;
- wherein said displacing redistributes loading within the knee joint by displacing the target tissue to achieve a therapeutic effect.
A method of treating a knee joint, the method comprising:
- selecting at least one of the muscles or connective tissues surrounding the knee joint as target tissue for treatment;
- attaching a device to the femur adjacent the knee joint, said device in engagement with the target tissue;
- displacing said target tissue by said engagement without severing the femur;
- and
- redistributing loading within the knee joint by displacing the target tissue more than about 5 mm from a pretreatment path to achieve a therapeutic effect.
A method of reducing a load in a lateral or medial compartment of the knee comprising:
- making an incision having an incision length;
- inserting an implant through the incision, the implant having an implant length substantially longer than the incision length;
- securing the implant to the femur on a first side of the knee using a fixation tool inserted through the incision without enlarging the incision;
- and
- displacing connective tissue with the implant such that the load is reduced in a compartment on an opposing side of the knee.
A device for reducing a load on an articular surface of a first bone of a joint comprising an implant having a fixation portion configured to be secured to the first bone and a displacement portion configured to displace connective tissue such that the load is reduced, wherein the fixation portion comprises a plurality of feet spaced apart along the implant, the implant engaging the first bone only on said feet.
A device for reducing a load on an articular surface of a first bone of a joint comprising an implant having a fixation portion configured to be secured to the first bone and a displacement portion configured to displace connective tissue such that the load is reduced, wherein the displacement portion is asymmetrical about a longitudinal axis of the implant.
A device for reducing a load on an articular surface of a first bone of a joint comprising an implant having a fixation portion configured to be secured to the first bone and a displacement portion configured to displace connective tissue such that the load is reduced, wherein, following implantation, the displacement surface is movable relative to the fixation portion when a force from the connective tissue exceeds a threshold force.
An implant system comprising:
- an implant for reducing a load on a first surface of a joint having a first bone, the implant comprising a fixation portion configured to be secured to the first bone and a displacement portion configured to displace connective tissue such that the load is reduced, the displacement portion having a first elevation relative to the first bone;
- and
- a transition prosthesis having an anchoring portion for securing to the first bone and a transition surface extending from a first region to a second region of the transition prosthesis, the transition surface sloping from the first elevation in the first region to a second elevation closer to a surface of the first bone in the second region.
Dependencies are inferred from the claim text.